Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial.

PURPOSE: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. MATERIALS AND METHODS: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. RESULTS: A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009). CONCLUSION: Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.

Unlinked anonymous HIV prevalence among New Zealand sexual health clinic attenders: 2005-2006.

This unlinked anonymous study aimed at determining the prevalence of HIV among sexual health clinic attenders having blood samples taken for syphilis and/or hepatitis B serology in six major New Zealand cities over a 12-month period in 2005-2006. Overall, seroprevalence was five per 1000 (47/9439). Among men who have sex with men (MSM), the overall prevalence and that of previously undiagnosed HIV were 44.1 and 20.1 per 1000, respectively. In heterosexual men, the overall prevalence was 1.2 per 1000 and in women 1.4 per 1000. HIV remains to be concentrated among homosexual and bisexual men. Comparison with a previous survey in 1996-1997 suggests an increase in the prevalence of undiagnosed HIV among MSM and also an increase in the number of MSM attending sexual health clinics. The low prevalence of HIV among heterosexuals suggests no extensive spread into the groups identified at risk of other sexually transmitted infections.

Male clients of female commercial sex workers: HIV, STDs and risk behaviour.

Social stigma and taboo limit current understanding of sexual behaviours and epidemiology of sexually transmitted infections (STIs) in clients of commercial sex workers/prostitutes. We designed a study to determine risk behaviours and prevalence of STIs in a group of sexual health clinic attending male clients of female commercial sex workers (FCSWs) in Sydney, and to compare these characteristics with men who denied any commercial sexual contact. Eight hundred and ninety cases and 2670 controls were included. Clients of FCSWs were older, more likely to be married and of non-English speaking background than controls. Clients had more sexual partners but reported more condom usage than controls. Prevalence of STIs at presentation was lower in clients than controls but clients were more likely to report STIs in the past than controls. HIV prevalence was low in both groups.

Seroprevalence of herpes simplex virus type 2 antibodies in New Zealand sexual health clinic patients.

AIM: To determine the prevalence of HSV-2 antibodies in STD clinic patients in Auckland and Christchurch between August 1991 and August 1992. METHODS: An unlinked anonymous HIV seroprevalence study was conducted in STD clinic patients in Auckland and Christchurch between August 1991 and August 1992. This cross-sectional seroprevalence study using stored sera and data from the HIV seroprevalence study, was conducted to determine the prevalence of antibody to herpes simplex virus type 2 (HSV-2). A random sample of 300 sera were analysed, using a type specific indirect enzyme-linked immunoassay (ELISA) to HSV glycoprotein G2 (gG-2) with Western blot confirmation of equivocal results. RESULTS: The seroprevalence was 25.7%. The seroprevalence increased up to age 50 years, but no significant differences were found for gender, or for European, Maori, or Pacific Island ethnic groups. The seroprevalence was significantly higher in sera obtained from patients attending the South Auckland STD clinic, than in that from Auckland central, west Auckland, or Christchurch clinics. CONCLUSIONS: We can conclude that infection with HSV-2 is common in STD clinic patients in New Zealand, and lies within the seroprevalence range of other similar studies from other countries.